Improving the Quality of Coronary Artery Bypass Grafting (CABG Quality)

National Center for Cardiovascular Diseases

Status: Begins enrollment in 1 month

Conditions: Coronary Artery Bypass Grafting (CABG)

Treatments: Behavioral: Interventions for healthcare professionals in hospitals with low usage rates; Behavioral: Interventions for healthcare professionals in hospitals with high usage rates

Study type: Interventional

Funder types: Other

Identifiers

NCT07377149

2025ZD0546704 (Other Identifier)

2025-2849

Details and patient eligibility

About

This is a healthcare quality improvement study focused on increasing the utilization of arterial grafts in isolated coronary artery bypass grafting (CABG). Evidence indicates that arterial grafts, compared with venous grafts, provide superior long-term patency, which are recommended to use by the clinical practice guidelines.

In hospitals where the use of the internal mammary artery as a graft is relatively low(<90%) among CABG patients, multiple interventions will be implemented to improve its adoption rate.

In hospitals where internal mammary artery graft utilization is already high(≥90%), various interventions will be introduced to promote the use of multiple arterial grafts (defined as the use of two or more arterial conduits).

The study targets healthcare professionals as the primary subjects of intervention, with no direct interventions applied to patients during the study period. Changes in the internal mammary artery graft utilization rate and the multiple arterial graft utilization rate before and after the intervention will serve as the primary endpoints for evaluating intervention effectiveness in the two types of hospitals, respectively.

Enrollment: 8,700 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

Patients whose data used to monitor the quality

Inclusion Criteria:

Aged ≥ 18 years old； Indicated for CABG and undergoing CABG.

Exclusion Criteria:

History of prior CABG; Concurrent other cardiac surgeries on the day of CABG; Malignant tumor or life expectancy < 1 year;

• 50% stenosis of left subclavian artery; Pregnant women; Individuals diagnosed with mental illness or cognitive impairment (International Classification of Diseases-10 codes F01-F99); Patients considered by the investigator to have other factors unsuitable for inclusion.

Trial design

Primary purpose: Health Services Research

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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8,700 participants in 1 patient group

Improving the utilization rate of arterial grafts for coronary artery bypass grafting

Other group

Description:

In this stepped-wedge cluster randomized trial (SW-CRT) with a self-controlled design, hospitals were categorized into two groups according to their internal mammary artery graft usage rates, thereby forming two SW-CRT. Healthcare professionals at these hospitals will receive tailored interventions. The effectiveness of each intervention is assessed by comparing the usage rates before and after implementation within each SW-CRT.

Treatment:

Behavioral: Interventions for healthcare professionals in hospitals with high usage rates

Behavioral: Interventions for healthcare professionals in hospitals with low usage rates